TBI: Massive Increase in Emergency room visits for kids with concussions

Researchers report a skyrocketing increase in the number of visits to the emergency department for kids with sports-related traumatic brain injuries (TBI), such as concussions.

The study, conducted by emergency physicians at Cincinnati Children's Hospital Medical Center, shows that emergency visits for sports-related TBI increased 92 percent between 2002 and 2011.

The number of children and teens admitted to the hospital with the same diagnosis also increased. That increase was proportionate to the increase in emergency department visits – about 10 percent.

Patients admitted during the later years of the time period had less severe injuries and stayed in the hospital shorter amounts of time.

"More people are seeking care for TBI in the emergency department, and proportionately more are being admitted for observation," says Holly Hanson, MD, an emergency medicine fellow at Cincinnati Children's and lead author of the study.

"Here in Cincinnati, we anticipate more children will be seeing their primary care physician or going to the Cincinnati Children's TBI clinic, due to the passage of recent Ohio legislation mandating medical clearance to return to play."

The study of emergency department trends in sports-related TBI is published online in the journal Pediatrics.

The researchers studied more than 3,800 children and teens who came to Cincinnati Children's with a sports-related TBI between 2002 and 2011. Of these patients, 372 were admitted.

Injury severity, however, decreased from 7.8 to 4.8, based on an established medical score to measure trauma severity. Length of stay changed little but trended downward.

Skiing, sledding, inline skating and skateboarding had the highest admission rates for patients who visited the emergency department.

Their research did not concentrate on why more children and teens with less severe injuries were admitted to the hospital during this time period.

They speculate that emergency physicians may be ordering fewer CT scans and observing patients in the hospital, or perhaps that athletes are getting bigger and stronger, causing more head injuries needing longer periods of observation.

The Centers for Diseases Control and Prevention has called TBI an "invisible epidemic" because these injuries are often profound but not readily apparent to the public.

TBI is responsible for approximately 630,000 emergency visits, more than 67,000 hospitalizations, and 6,100 deaths in children and teens each year.

Medical evaluations for sports-related TBI increased 62 percent between 2001 and 2009, according to previous studies.

More Information: Sports related head injuries
Read more about minor head injuries on children

Music decreases perceived pain for children in Pediatric ER

Newly published findings by medical researchers at the University of Alberta provide more evidence that music decreases children's perceived sense of pain.

Faculty of Medicine & Dentistry researcher Lisa Hartling led the research team that involved her colleagues from the Department of Pediatrics, as well as fellow researchers from the University of Manitoba and the United States.

Their findings were published in the peer-reviewed journal JAMA Pediatrics today.

The team conducted a clinical research trial of 42 children between the ages of 3 and 11 who came to the pediatric emergency department at the Stollery Children's Hospital and needed IVs.

Some of the children listened to music while getting an IV, while others did not. Researchers measured the children's distress, perceived pain levels and heart rates, as well as satisfaction levels of parents, and satisfaction levels of health-care providers who administered the IVs.

The trial took place between January 2009 and March 2010.

"We did find a difference in the children's reported pain – the children in the music group had less pain immediately after the procedure," says Hartling.

"The finding is clinically important and it's a simple intervention that can make a big difference. Playing music for kids during painful medical procedures would be an inexpensive and easy-to-use intervention in clinical settings."

The research showed that the children who listened to music reported significantly less pain, some demonstrated significantly less distress, and the children's parents were more satisfied with care.

"There is growing scientific evidence showing that the brain responds to music and different types of music in very specific ways," said Hartling.

"So additional research into how and why music may be a better distraction from pain could help advance this field."

The study noted that previous research has shown that the mood of the music, whether it has lyrics, and whether it is familiar to the listener could have an impact on pain perception as well.

Protect your kids from pollen allergies

Many children suffer allergies at this time of year as trees and other plants start releasing pollens into the air.

So parents need to monitor their youngsters for symptoms, an expert says.

"There are different types of allergies, but if you notice that your child has more symptoms and reactions during the spring it's a clue that they have a pollen allergy," Dr. Joyce Rabbat, a pediatric allergist at Loyola University Chicago Stritch School of Medicine.

Symptoms of pollen allergies—which are most likely to be worse on dry, windy days—include itchy eyes, sneezing, stuffy/runny nose, coughing and asthma.

Dr. Joyce Rabbat

"If your child's allergy symptoms are interfering with his or her daily life, there is no reason to let the child suffer. Allergy symptoms are very treatable. Some people think it's just something they need to 'live with' but that's not the case," Rabbat said.

She said parents can take the following steps to help reduce children's allergy symptoms:

• Check pollen counts and limit children's time outside when the counts are high.
• Keep windows and doors closed, especially on high-count days. This will help limit the amount of pollen that lands on furniture and carpets.
• Turn on your air conditioner to filter pollen from the air within your house. Have children wash their face and hands when they come in from outdoors.
• A shower and change of clothes can take pollen off the body.

"If your child is active outdoors or in sports, make sure he or she takes allergy medication before heading outside," Rabbat said.

Parents also need to watch for asthma symptoms because many children with allergies also have allergic asthma.

Symptoms of allergic asthma include coughing, shortness of breath, rapid breathing, wheezing and a feeling of tightness in the chest.

"Often treating children's allergies helps to control their asthma as well. Kids may need to take an allergy medicine before going outside, or they may need daily allergy medication.

It's also important to get ahead of your allergy symptoms.

Once allergies are flaring, they become more difficult to treat. If you are on a good medication regimen before the pollens peak, it makes for a much more enjoyable season," Rabbat said.

More information: 
The Nemours Foundation has more about seasonal allergies in children HERE.

Cesar Milan - The Dog Whisperer speaks about Kids connection with Dogs

I have great respect for Cesar Milan and the work he does. He is an example to all dog owners and parents.

He has taught me so much through his programs and writings that I feel I should share this article with you and invite you to read more of his sage advice on his Blog site. -

"Friday was National Kids and Pets Day in the US. If you’ve had both at the same time, then you know that children, especially toddlers, are naturally drawn to animals, particularly dogs, and that calm, balanced dogs have a natural affinity for children."

Most of you reading this probably know that my life-long love for animals also goes back to my childhood, and I was even nicknamed “Dog Boy” because of it. My sons are the same way, especially Calvin, who is growing into a fine Pack Leader.

Here’s my question to you: Why do you think that most kids and dogs get along so well?

The reason is simple: Young children, like dogs, tend to be instinctual. They are very direct in their communication, and they do it through energy, intention, and body language. Dogs can understand and relate to this, because that’s how they communicate, too.

Facial Expressions
Some studies indicate that dogs can read human facial expressions as well, and if there’s one thing young children are not good at, it’s hiding their thoughts or emotions — if a kid thinks it or feels it, it shows up on their face.

Perhaps this is why dogs don’t necessarily react nervously or aggressively when that giggly toddler comes running up to them screaming in delight — they can instinctively understand that the gesture is the same as another dog initiating play, rather than a threat.

Dogs Can Bite
However... there are plenty of stories in the news about children being bitten, maimed, or worse by dogs, whether it was the beloved family pet or a strange dog on the loose, and it is very important from early on to teach our children basic dog safety.

Even an adult can be bitten by taking the wrong approach with a dog (it’s happened to me a time or two!), and it’s much easier for kids to accidentally take the wrong approach.

While I do teach that we should relate to our dogs instinctively,  that’s something for much older kids and grown-ups.

With young kids, we have to teach them to approach dogs intellectually first, then let them re-discover their instincts later.

Respect Their Space
We have to begin by teaching our children to respect a dog’s space, and never approach in a way that might startle or frighten the dog. They should never run at a dog with excited energy, and never chase a dog that is trying to avoid them.

When petting a dog, they should do it gently, and always under the chin or on the chest, never by reaching over the dog’s back and, most importantly, they should never, ever approach a strange dog, especially if it’s alone; otherwise, they should ask the dog’s caretaker first if it’s all right.

Supervision
These rules apply to the pets in your own home as well, and you should never leave your dogs and young children together unsupervised.

Infants especially like to grab things — remember, to humans, touch is a very important way of learning about the world — and even the friendliest dog can react badly to suddenly having its tail or ears yanked.

Respect and Care
If you teach your very young children to approach animals with respect and care, it will not only help keep them safe, but educate them on how to treat animals for life, so they can have many rewarding experiences with them as they get older. Pets are also the perfect way to teach older children empathy and responsibility — two of the most important skills they can have as adults.

And, as adults, we can learn from our young children all over again how to approach the world with that sense of instinctual joy and curiosity that draws them to animals in the first place, but to do it in a way that is safe and rewarding for everyone involved, human and dog alike.

Read more of Cesar's articles here

How to Motivate Kids to Read: Tips - Andrea Davis Pinkney video

Children's book author Andrea Davis Pinkney, who has children with learning disabilities, shares fantastic tips about how to motivate young people to read. For more information and free resources, please visit NCLD's Dyslexia page.

Children Exposed to Mercury, Lead at High Risk of ADHD - Canada study

Young children exposed to certain heavy metals are at higher risk for problems with attention and behaviour later in life, a new study shows.

The study followed nearly 300 Inuit children who were born in northern Quebec, Canada.

One of the main sources of protein in the Inuit diet is beluga whale meat, which can be high in mercury.

Inuit children are exposed to lead when they eat shot pellets that are used to kill geese and ducks.

Lead and mercury are potent toxins, and the developing brains of young children are vulnerable to their effects.

Mercury Poisoning
Studies of kids with mercury poisoning show they have trouble with language skills, attention, and coordination, as well as other problems.

Mercury poisoning can result in several diseases, including acrodynia (pink disease), Hunter-Russell syndrome, and Minamata disease.

Lead Poisoning
Lead poisoning also affects learning and memory.

Lead interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestines, kidneys, and reproductive and nervous systems.

It interferes with the development of the nervous system and is therefore particularly toxic to children, causing potentially permanent learning and behaviour disorders, such as ADHD/ADD.

Researchers tested a sample of Inuit children's umbilical cord blood at birth for a range of environmental contaminants and nutrients.

Years later, when the children were between the ages of 8 and 14, researchers asked their teachers to complete questionnaires about their behaviour.

Roughly 14% of the children in the study had inattentive behaviours of attention deficit hyperactivity disorder (ADHD). A similar percentage of the children had hyperactive-impulsive behaviours of ADHD.

Mercury and Lead Linked to More Symptoms of ADHD
Children with the highest concentrations of mercury in their cord blood had more trouble paying attention than those with lower levels.

They were also about three times more likely to be flagged by their teachers as having these symptoms of ADHD.

That was true even after researchers accounted for things linked to ADHD, like low birth weight and whether or not the mother used tobacco during pregnancy.

Researchers say the mercury levels seen in the study were extremely high. Most women of childbearing age in the U.S. have blood levels of mercury that are about one-third as high, according to the CDC.

Certain groups of people, like Asian-Americans born in China, who eat traditional diets rich in large fish like shark, tuna, and swordfish, have been found to have blood levels of mercury that are in the same extreme range as found in this study, says researcher Gina Muckle, PhD, of Laval University in Quebec, Canada.

In contrast, Inuit children with even low to moderate blood levels of lead -- closer to levels measured in some U.S. children -- were more than four times more likely to have problems with hyperactivity than kids with lower lead levels.

"The effects we are seeing are at very low levels of exposure. In [the] U.S. and Canada, for example, we estimate that 10% of children would be exposed to these blood lead levels," says Muckle.

U.S. children can be exposed to lead when they eat tiny chips of lead-based paint, which can be found in homes built prior to 1978.

The study (Prenatal Methylmercury, Postnatal Lead Exposure, and Evidence of Attention Deficit Hyperactivity Disorder among Inuit Children in Arctic Québec) is published in Environmental Health Perspectives. It was paid for by government grants from the U.S. and Canada.

School For Kids With ADHD, Dyslexia Boasts Record Enrollment

Marburn Academy began the new school year today with enrollment at an all-time high. The private school in the Northland area has been educating students with ADHD and dyslexia for more than thirty years.

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